Category Archives: sex therapy

2025 Round Up

Posted on by Julia

“Satisfaction” was my focus, the word I kept coming back to in 2025. 2025 was about relationship and being present. I decided to let go of some work extracurriculars (adjunct teaching and organizing trainings) after years of service and achieving my goals there. Today, all my work hours relate to providing direct therapy. I’m lucky to find vitality in my work among other things. There’s always something to notice, something to feel. I’ll always be interested in how different individuals relate and respond to challenges. 

Here’s a few thoughts related to my work this year. 

Risk-taking. Simply put, you can’t grow without taking risks. However, sometimes risk-taking is ill-conceived. How do you know if you’re self-sabotaging by being too impulsive? Or on the other hand, too risk-adverse? Are you engaged in the spirit of learning and collaboration? Will you integrate experience and feedback into future decisions? Healthy risk-taking is closely related to integrity (authenticity) and courage. At the same time, you also need to gauge the context correctly, without too much confirmation bias.

Dialectical processing. Dialectics are feeling/thinking more than one thing at the same time, often in paradox. For example, “I really care about her and I’m not going to help in this particular situation for this specific reason. I will care in some other way.” When contemplating a decision, dialectical processing helps explore multiple perspectives before deciding. It honors what we think holistically, not just the current reaction or trigger. Often, people have certain go-to feelings that become comfort zones and may cling to outdated beliefs. Sometimes people may over-compartmentalize unpleasant feelings and/or “drink the kool-aid.” Other times they may cling to unpleasant feelings rather than dare see opportunity for change. Using a feelings wheel, when contemplating an emotionally-charged situation, can you identify at least 3 emotions (some of them being somewhat contradictory) rather than just one? 

Fantasies. Similarly, exploring client fantasies can help dig deeper into someone’s wounds or desires. Fantasies are not typically linear or literal but may offer a pathway into feelings and discovery. It makes sense that people are drawn to ideas that go beyond their day-to-day experiences. If there’s a problem, we can learn more by asking about difficulties in the person’s current (or past) reality. What’s their mind’s fantastical “solution”, even if it’s unsuitable? Does it point to any real symptoms, like personality disorders, or OCD? Does it signify some kind of growth edge through creative fiction or symbolism? Actively exploring or developing growth edges may be tedious compared to fantasizing; however, there’s usually a way to apply one’s insights. 

Compassion. Probably my favorite training this year was an introduction to Compassionate Inquiry with Gabor Mate. I keep going back to the 4 levels of compassion he outlined: 1) I feel bad you’re suffering, 2) I want to understand why you suffer, 3) I recognize there’s nothing in you that I don’t experience in some way, and 4) I’m not scared of feelings themselves, I want to get to the truth about what you feel. This Compassionate Inquiry theory advises it’s ultimately more compassionate to understand the person fully rather than just (temporarily) soothe them. Trauma is “disconnection from self.” Although it takes more than just showing up to therapy, a therapist can assist someone in self-reconnection.   

As far as continuing education goes, besides the Compassionate Inquiry course, I attended the annual conferences for the American Academy of Psychotherapists and the American Association of Sexuality Counselors, Educators, and Therapists. Other highlights were Whole Person Supervision, Understanding Traumatic Narcissism Theory, and EMDR with Brain Injuries. 

I also did 9 months of therapy as a client in 2024-2025. Onward!

2024 Continuing Education

Posted on by Julia

This 14th year of business was a mixture of delving into some new content; reviewing the basics; and specialized training. I love the variety of sources to inspire my work–and the challenge to tailor experience with each particular client.

I went to a workshop about “divine” and “shadow” femininity and masculinity earlier this year. As a therapist and sex therapist, of I’ve been analyzing relational and internal energies my whole life. I see some real limits to associating energies with gender. At the same time, the lens of “divine” feminine and masculine is an interesting way to highlight qualities that someone of any gender can incorporate into life, with or without a partner. I’m also fascinated by the shadow aspects. While some contexts may prescribe gender roles, they are silent on the shadow side–the problematic ways that gender roles hurt people. In this other framework, divine femininity relates to deep strength in vulnerability, creativity, radiance, acceptance, presence, compassion, timelessness, and flow. Toxic or shadow femininity is associated with hyper-etiquette, passive aggression, gossip, perfectionism, false humility, covert competition, and/or helplessness. Shadow (or “toxic”) masculinity, as many of us know, relates to violence, aggression, entitlement, hostility, impulsivity, bravado, and being caviler. Divine masculinity is protective, providing, initiating, activating, adventurous, focused, grounded, and direct. Anyone can have any of these traits. The shadow sides of each relates to how people cause harm and/or unconsciously sabotage themselves. This framework is one of a thousand that can help us self-assess our growth edges and practice them with ourselves and in relationships.

Another workshop I took this year was back to basics: Interpersonal Psychotherapy (IPT). It’s a comprehensive treatment theory for depression, anxiety, and trauma that involves assessing and treating 4 domains: interpersonal disputes, role transitions, grief, and interpersonal deficits. Intervention techniques include communication analysis, interpersonal inventory, role playing, assertiveness training, and building social support. I also studied an Interpersonal Process Approach book (different from IPT) with a supervisee.

For sex therapy, I attended the AASECT national convention again. This year’s workshops included:

  • The Room Nextdoor: Neural networks and Sexuality (with Emily Nagoski, author of Come As You Are and Come Together)
  • The Fight for LGBTQ Rights in an Age of Fear-Based Politics (with Representative Zooey Zephyr)
  • Black Male Sexualization (with Yamonte Cooper)
  • Intersex Narratives: Navigating Identity, Advocacy, and Sexual Health (with (Pidgeon Pagonis)
  • Navigating Intimacy with Autism
  • Reimagining Menopause and Beyond: A Journey of Empowerment and Clarity
  • Sexual and Reproductive Kinks
  • Centering Latinidad in Sex Education, Counseling, y Therapy
  • Assessing Sexual Dysfunction and Preventing Early Onset Psychosis

Additionally, I started learning how to combine two of my specialties. I took a course in combining EMDR and Ketamine-Assisted Therapy. It helped me sharpen both skill sets and develop a couple protocols for combined treatment. Both EMDR and Ketamine-Assisted therapies may help tap into unconscious material and enhance neuroplasticity. This is a treatment option for some people with depression and trauma.

I also completed my last year coordinating trainings with the Queer Affirming Therapist Guild and attended the American Academy of Psychotherapist conference (previous blog post). It’s been a great year!

Beliefs about Growth & Change

Posted on by Julia

Here are the nuts and bolts–what I think I know about change and resilience

  • The capacity to fully experience both pleasant and unpleasant experiences is key. A wide Window of Tolerance is healthy.
    • Avoidance and denial are only useful short-term survival strategies. Are you able to fully experience and express your unpleasant experiences in real time? Or the soonest appropriate time? This is what grief processing is all about. If the pain is not honored, it may be waiting in the wings to surprise you and project itself into even more situations down the road. Take your devastation seriously (yet don’t act impulsively). Acceptance and meaning develop out of emotional truth (both pleasant and unpleasant truths).
    • Less discussed is Positive Affect Tolerance. Positive affect tolerance is the ability to fully embrace pleasant experiences (love, joy, success, etc). Many folks harbor unconscious fear when a pleasant experience presents itself because they are bracing themselves from future disappointment and pain. They would rather control their experience than ride the emotional highs and lows. This emotional numbing is an understandable strategy yet ultimately limits internal and external connections.
  • Grief is a part of life. If you want to minimize the expense of therapy in your healing journey, you may want to do some serious grief journaling
  • Identify the emotional longing underneath your disappointments, frustrations, and desires. What are you truly longing for? It may not be in line with your initial words or assumptions. For example, if you’re overtly wanting sex, you might be longing to play, be cherished, or to connect. Once you clearly identify your deep emotional longing, you can generate additional approaches.
  • Congruence is vitality. Congruence means authenticity; we can be respectful without masking. Therapy may be a low-stakes opportunity to increase your genuine self-expression, a key ingredient for both autonomy and intimacy.
  • When magic happens in therapy, it’s usually around a Corrective Emotional Experience. If a client is repeating any unconscious patterns or assumptions, I do my best to respond in a way that is helpful, yet goes off-script from the pattern. Relational dynamics that are experienced earlier in life sometimes become expected, maybe even facilitated, unconsciously. The corrective emotional experience can open doors that may increase relational options outside of therapy. This kind of exploration is a huge part of what makes therapy different from other relationships, like friendships or colleagues.
  • Projections. There are a million things I could say about projections. They can wreck havoc on relationships or, if brought to awareness, can be useful in self-development. Recognizing projections can lead to healthy vulnerability and communication. Everyone makes projection errors. When we recognize projections, we can practice self-compassion and repair.
  • Inner child. Self-parenting is cheesy but real, valid, and often necessary. Neglect is gradually healed by taking the inner child seriously and responding with appropriate, consistent self-care (and community-care if you can find it). Our younger selves can be attended to in the here & now.

2022 & 2023 Continuing Education

Posted on by Julia

Here’s a quick list of my studies the last couple years…I love my job!

(My year with the Integrative Psychiatry Institute is included in prior posts, skipping it here)

SUPERVISION

  • Clinical Supervision: Ethics & Effective Practice*
  • Ethical Frameworks for Multiple (Dual) Relationships

SEXUALITY

  • Minimizing STI Stigma with Inclusive Education
  • Building Queer Families: Conception, Emotional & Legal Issues, and Resources^
  • Sex Positivity: what it is and isn’t
  • Issues & Clinical Implications around BDSM/Kink and Non-Suicidal Self-Injury*
  • Sex & Consent in Contemporary Youth Culture
  • Decolonizing Mental Health & Sexuality through Irreverent Comedy
  • Sex after Sexual Assault
  • Pelvic Floor Health and Vitality: from Pain to Pleasure*
  • Trauma-Informed Assessment of LGBTQ+ Youth^
  • Emerging Trans: Therapists’ Role in Supporting TNB Young People^
  • LGBTQ+ Older Adults: Strategies and Recommendations^
  • Non-Monogamy/Polyamory Panel^
  • Rewiring Trauma through Kink^
  • Gender-Affirming Letter Writing for Clinicians^
  • Play Therapy with LGBTQ+ Youth: Caring for the Child, Collaborating with the Parent^

EMDR

  • Easy Ego State Interventions*
  • EMDR & Mindfulness*

OTHER

  • Ethics of Self-Disclosure
  • Suicide Prevention
  • Grief & Bereavement in LGBTQ+ Communities^
  • Borders & Walls: Facing the Other*
  • Differential Diagnosis with DSM 5*

*Longer events, ranging from 4 hours through 4 days

^Events I volunteer organized speakers for the Queer Affirming Therapists Guild

2021 Continuing Education

Posted on by Julia

I attended and organized many programs this year. LMK if you would like to discuss!

I attended:

  • Sexual Development and Attitudes of African American Women
  • Sex and Sexuality in the Muslim Community
  • More than Medicine: Alternative Treatments for ADHD
  • Sex Therapy with Religiously Conservative Clients
  • Inter-generational Transmission of Trauma on Adult Sexual Intimacy
  • Couples After Pregnancy: Intimacy & Sexuality
  • Racial Literacy: Racial Stress in Therapeutic Relationships

I also organized events through the LGBT Affirmative Therapists Guild. I facilitated the event & discussion and other professionals presented on the following topics:

  • Hormone Therapy with Transgender Clients (medical provider panel)
  • Weight Stigma
  • HIV+: What Therapists Need to Know
  • Lesbian-Affirming Client Care
  • Reflections from LGBTQ Community Members

2020 Continuing Education

Posted on by Julia

Here are some workshops I attended since my last update:

  • Pros/cons of forgiveness after trauma
  • treatment planning
  • suicide assessment
  • treating dissociation with EMDR (with Dolores Mosquera)
  • restoring sexual development via body-based therapies (with Dr. Nan Wise)
  • practicing during Covid-19: ethical & risk management
  • Black & White therapeutic dyads (with Dr. Laurie Paul)
  • developmental impact of shame
  • negotiating racial stress within a therapeutic relationship (with Dr. Howard C. Stevenson)
  • roots of self-sabotage
  • religious trauma: negative effects of purity culture
  • gender expansive & Non-Binary clients
  • sexual taboos within the Black community (with Christina Wright, MPH)
  • intimacy & sexuality after pregnancy (with Dr. Stephanie Buehler)

I also started a new EMDR Certification process through EMDR-specific supervision

On Fire

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I’ve been reading Woman on Fire: 9 Elements to Wake up your Erotic Energy, Personal Power, and Sexual Intelligence. The 9 elements are: Voice, Release, Emotion, Body, Desire, Permission, Play, Home, and Fire. Amy Jo Goddard offers worksheets and exercises in each chapter to help individual women explore their sexual stories while identifying any stuck-ness, growth edges, preferred experiences, and experiments. I appreciate the practical applications with the worksheets and journal prompts. If this is your jam, I’d be happy to support your process.

Tantra Sexuality & Sacred Intimacy

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I participated in a two-day couple’s workshop in Tantric Sexuality lead by Dr. Sally Valentine. Tantra is a special practice due to it’s concurrent engagement of the mind, body, emotions, and spirit.  Tantra emphasizes a person’s internal body consciousness and self-love as a foundation for connection with a loved one. This foundation & specific practices facilitate neural synchronicity between lovers with heightened non-verbal communication. I learned at least 12 non-verbal practices and 6 verbal practices for increased relational intimacy. I’d be happy to share these techniques with you!

Decentering the Norm

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I attended a 3-day workshop titled “Decentering the Norm: Social Justice Transformations in Sex Therapy, Counseling, and Sex Education.” Some highlights included:

  • sex tools that enhance or enable pleasure for people with disabilities
  • connecting pleasure with personal power and agency (rather than, for example workaholism)
  • a discussion of “sanism” and introduction to Mad Studies
  • how queer theory intersects and modifies attachment theory